Gut ischemia and reperfusion (IR), for example in small bowel transplantation or following resuscitation, may result in severe impairment of the intestinal microcirculation. Potential sequelae are mucosal damage, loss of barrier function, bacterial translocation, systemic inflammation, multiple organ failure and death. We hypothesized that extracellular adenosine signalling has a protective role in intestinal IR injury. Using intravital microscopy we investigated the effects of the adenosine receptor agonist NECA (5'-N-ethyl carboxamide adenosine) on leukocyte-endothelial interactions and capillary perfusion in the intestinal microcirculation following intestinal IR.

The data support the hypothesis, that adenosine signalling is involved in intestinal IR injury. The adenosine A2B receptors are more important than adenosine A1 receptors since inhibition of A2B receptor by MRS1754 completely reversed the effect of the adenosine receptor agonist NECA.